Active NPI
Paul Joseph Kullman
- General Practice Dentistry
- Malone, NY
National Provider Identifier
1154466167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DT00002348
- Practice address
- 134 Park St
Malone, NY 12953-1251 - Phone
- (518) 481-2347
- NPI assigned
- Feb 20, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DT00002348 | NY | Primary |
Addresses
Primary practice location
134 Park St
Malone, NY 12953-1251
Mailing address
70 Simonds Hill Road
Post Office Box 29
New Russia, NY 12964
Phone (518) 873-6430
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT00002348 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154466167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 SIMONDS HILL ROAD",
"address_2": "POST OFFICE BOX 29",
"city": "NEW RUSSIA",
"state": "NY",
"postal_code": "12964",
"telephone_number": "518-873-6430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 PARK ST",
"city": "MALONE",
"state": "NY",
"postal_code": "129531251",
"telephone_number": "518-481-2347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KULLMAN",
"first_name": "PAUL",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "DT00002348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malone, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.